Features of Patients With Out-of-Hospital Cardiac Arrest and
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This study aimed to assess the clinical and angiographic characteristics of patients with acute myocardial infarction (MI) and out-of-hospital cardiac arrest (OHCA).

This was a retrospective analysis of 480 consecutive patients with acute MI undergoing percutaneous coronary intervention. Patients complicated with OHCA were compared with patients without OHCA. This study is unique in aggressive and early use of percutaneous cardiopulmonary support system allowing for a larger group of patients with OHCA to be assessed with coronary angiography.

-- Of the patients, 141 (29%) were complicated with OHCA.
-- Multivariate analysis revealed that age, estimated glomerular filtration rate, peak creatine kinase-myocardial band, calcium-channel antagonists use, the culprit lesion at the left main coronary artery and the presence of chronic total occlusion were significantly associated with OHCA.

Younger age, no use of calcium-channel antagonists, worse renal function, larger infarct size, culprit lesion in the left main coronary artery, and having chronic total occlusion were associated with OHCA, conclude authors.

The current study is from hospital systems in Japan where percutaneous cardiopulmonary support systems (venoarterial extracorporeal membrane oxygenation) are instituted early and frequently, which allowed for patients who might have otherwise died prior to angiography to be included in the analysis. Of the predictors defined, use of calcium channel blockers being protective suggests that coronary spasm may have played a role among the cohort studied. In-hospital mortality for OHCA survivors in this inclusive cohort was approximately 60%.

Source: https://www.onlinejacc.org/content/76/17/1934?_ga=2.33186558.1307854152.1603287006-777820309.1584504539